Restructuring of anterior cruciate ligament transplant according to mri data
DOI:
https://doi.org/10.15674/0030-59872016455-61Keywords:
anterior crucial ligament graft, MRI, ligamentation criteriaAbstract
Anterior crucial ligament (ACL) injury is one of the most common injuries of the knee. Magnetically resonance imaging (MRI) is an important method to evaluate and identify the transplant complications associated with ACL reconstruction.
Objective: to develop criteria for evaluating new criteria of ACL graft restructuring. Methods: 95 patients at 3, 6, 9 and 12 months after ACL restoration using MRI are studied. ACL remodeling evaluated by MRI-signal intensity in T2 and proton density-weighted sequences (PDW), as well as the degree of homogeneity, using tribal scale. To eliminate subjectivity analysis of MRI-pictures used ratio signal/noise ratio. Data compared to intact ACL in 50 patients is obtained.
Results: values of the signal/noise ratio (SNR) decreases from 3 to 9 months after the surgery, indicating graft restructuring during this period in all its parts (femoral, tibial and median). There is no difference in ratio signal/noise coefficient obtained 9 and 12 months after the surgery. It is found that even after 12 months after the operation signal intensity of ACL transplantation does not reach intact ligament values.
Conclusion: it is developed method of evaluating the dynamics of recovery after ACL graft using the analysis of MRI images. It involves determining signal strength using the signal/ noise ratio and qualitative evaluation of ACL graft with general view uniformity using tribal scale. It is developed criteria of MRI evaluation for intraarticular ACL graft restructuring. The results should be considered when planning a program of rehabilitation and development of methods aimed at the acceleration of biological graft remodeling after ACL reconstruction.References
- Strafun SS, Sergienko RО, Strafun ОS, et al. Causes of recurrence antero-medial knee instability. Messenger orthopaedics, traumatology and prosthetics. 2010;3:14-20.
- Strafun SS, Sergienko RО, Strafun ОS, et al. Forecasting results of treatment patients with antero-medial knee instability. Orthopaedics, traumatology and prosthetics. 2012;2:64-67
- Menetrey J, Duthon VB, Laumonier T, Fritschy D. «Biological failure» of the anterior cruciate ligament graft. Knee Surg. Sports Traumatol. Arthrosc. 2008;16(3):224–231. DOI: 10.1007/s00167-007-0474-x.
- Weiler A, Peters G, Maurer J, et al. Biomechanical properties and vascularity of an anterior cruciate ligament graft can be predicted by contrast-enhanced magnetic resonance imaging: a two-year study in sheep. Am J Sports Med. 2001;29(6):751–761.
- Chen CH. Graft healing in anterior cruciate ligament reconstruction. Sports Med. Arthrosc. Rehabil. Ther. Technol. 2009;1(1):Article 21. DOI: 10.1186/1758-2555-1-21.
- Crawford SN, Waterman BR, Lubowitz JH. Long-term failure of anterior cruciate ligament reconstruction. Arthroscopy. 2013;29(9):1566–1571. DOI: 10.1016/j.arthro.2013.04.014.
- Deehan DJ, Cawston TE. The biology of integration of the anterior cruciate ligament. J Bone Joint Surg. Br. 2005;87(7):889–895. DOI: 10.1302/0301-620X.87B7.16038.
- Lee BI, Kim BM, Kho DH, Kwon SW, Kim HJ, Hwang HR. Does the tibial remnant of the anterior cruciate ligament promote ligamentization? Knee. 2016;23:160–168. DOI: 10.1016/ j.knee.2016.09.008.
- Zaffagnini S, De Pasquale V, Marchesini Reggiani L, Russo A, Agati P, Bacchelli B, Marcacci M. Electron microscopy of the remodelling process in hamstring tendon used as ACL graft. Knee Surg. Sports Traumatol. Arthrosc. 2010;18(8):2105–2108. DOI: 10.1007/s00167-009-0925-7.
- Gohil S, Annear PO, Breidahl W. Anterior cruciate ligament reconstruction using autologous double hamstrings: a comparison of standard versus minimal debridement techniques using MRI to assess revascularization. J Bone Joint Surg Br. 2007;89(9):1165–71. doi: 10.1302/0301-620X.89B9.19339.
- Hodqson RG, O'Connor PJ, Grainger AJ. Tendon and ligament imaging. Br J Radiol. 2012;85(1016):1157–72. doi: 10.1259/bjr/34786470.
- Sánchez M, Anitua E, Azofra J, Prado R, Muruzabal F, Andia I. Ligamentization of tendon grafts treated with an endogenous preparation rich in growth factors: gross morphology and histology. Arthroscopy. 2010;26(4);470–80. doi: 10.1016/j.arthro.2009.08.019.
- Figueroa D, Melean P, Calvo R, Vaisman A, Zilleruelo N, Figueroa F, Villalón I. Magnetic resonance imaging evaluation of the integration and maturation of semitendinosus-gracilis graft in anterior cruciate ligament reconstruction using autologous platelet concentrate. Arthroscopy. 2010;26(10):1318–25. doi: 10.1016/j.arthro.2010.02.010.
- Mariscalco MW, Flanigan DC, Mitchell J, Pedroza AD, Jones MH, Andrish JT, Parker RD, Kaeding CC, Magnussen RA. The influence of hamstring autograft size on patient-reported outcomes and risk of revision after anterior cruciate ligament reconstruction: a Multicenter Orthopaedic Outcomes Network (MOON) Cohort Study. Arthroscopy. 2013;29(12):1948–53. doi: 10.1016/j.arthro.2013.08.025.
- McRobbie DW, Moore EA, Graves MJ, Prince MR. MRI from picture to proton. 2nd ed. Cambridge: Cambridge University Press, 2006. Available from: https://ucrfisicamedica.files.wordpress.com/2010/10/mri.pdf.
- Plotkin BE, Agarwal VK, Varma R. Stump entrapment of the torn anterior cruciate ligament. Radiol. Case Rep. 2016;4(1):268–72. doi: 10.2484/rcr.v4i1.268.
- Vogl TJ, Schmitt J, Lubrich J, Hochmuth K, Diebold T, Del Tredici K, Südkamp N. Reconstructed anterior cruciate ligaments using patellar tendon ligament grafts: diagnostic value of contrast enhanced MRI in a 2 year follow-up regimen. Eur Radiol. 2001;11:1450–1456. DOI: 10.1007/s003300100870.
- Janssen RP, van der Wijk J, Fiedler A, Schmidt T, Sala HA, Scheffler SU. Remodelling of human hamstring autografts after anterior cruciate ligament reconstruction. Knee Surg. Sports Traumatol. Arthrosc. 2011;19(8):1299–306. doi: 10.1007/s00167- 011-1419-y.
- Claes S, Verdonk P, Forsyth R, Bellemans J. The «ligamentization» process in anterior cruciate ligament reconstruction: what happens to the human graft? A system¬atic review of the literature. Am J Sports Med. 2011;39(11):2476–83. doi: 10.1177/0363546511402662.
- Dustmann M, Schmidt T, Gangey I, Unterhauser FN, Weiler A, Scheffler SU. The extracellular remodeling of free-soft-tissue autografts and allografts for reconstruction of the anterior cruciate ligament: a comparison study in sheep model. Knee Surg. Sports Trau¬matol. Arthrosc. 2008;16(4):360–9. doi: 10.1007/s00167-007-0471-0.
- Stener S, Ejerhed L, Movin T, Sernert N, Papadogiannakis N, Kartus J. The reharvested patellar tendon has the potential for ligamentization when used for anterior cruciate ligament revision surgery. Knee Surg Sports Traumatol Arthrosc. 2012;20:1168–74. doi: 10.1007/s00167-012-1908-7.
- Stöckle U, Hoffmann R, Schwedtke J, Lubrich J, Vogl T, Südkamp NP. Value of MRI in assessment of cruciate ligament replacement. Unfallchirurg. 1997;100(3):212–8.
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